Published online Nov 2, 2015. doi: 10.5314/wjd.v4.i4.135
Peer-review started: June 23, 2014
First decision: August 14, 2014
Revised: June 24, 2015
Accepted: July 16, 2015
Article in press: July 17, 2015
Published online: November 2, 2015
Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitate other dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published “mimickers” of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.
Core tip: Mycosis fungoides, the most common cutaneous lymphoma, may imitate diverse diagnoses both on clinical and on histological grounds. Hence, the former “great masquerader” syphilis may be regarded as being outpaced. As diagnosis of such ambiguous, atypical cases of mycosis fungoides may be a challenge for the dermatologist and pathologist and consecutively adequate therapeutic measures may be delayed we herein give a comprehensive overview on previously published cases accomplished by our own data. We conclude that a multi-step diagnostic algorithm including meticulous clinicopathological correlation together with molecular genetic analysis should be applied in such protean cases to obtain the correct diagnosis.